Enophthalmos is an eye condition which is characterized by the recession of the eyeball into the orbit. It is also defined as the posterior displacement of the eye. The most common way to measure the anterior projection of the eye is by relatively comparing it to the outer edge of the orbit. This outer edge of the orbit is also known as the orbital rim. Another way to assess the anterior projection of the eye is by comparing it to maxillary and frontal projections.
Clinical Features of Enophthalmos
Old photographs or radiographic studies are mandatory for determining bilateral enophthalmos. But in the case of unilateral enophthalmos, it becomes quite obvious when you compare one eye with the other. There are some physical changes which are mentioned below:
- Lost fullness of fat bulge in upper and lower eyelids
- Superior sulcus deformity (deepened upper eyelid crease)
- Narrowed vertical eyelid fissure. It is also known as globe ptosis or hypoglobus. It may be normal or widened, if associated with posterior displacement of the eye.
Depending on the etiology, some other physical findings are:
- Blue skin might imply vascular malformation
- Thickened indurated skin may indicate metastatic scirrhous carcinoma
- Thinned fat, muscle, skin or bone may indicate linear scleroderma or Parry-Romberg syndrome
- Decreased function of either of the first 2 divisions may also indicate cavernous sinus involvement or tumor infiltration
- Decreased function of 2 division may indicate nerve entrapment in fracture
Eyelids and Skin
Fifth Nerve Function
Ocular motility may indicate a restrictive process (fracture) or mass (orbital tumor).
Exophthalmometry measurement is necessary to establish stability or progression.
Causes of Enophthalmos
- Pseudoenophthalmos
- Volumetric loss of orbital contents
- Expansion of orbital cavity
- Inadequate, postnatal, orbital cavity
